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HomeMy WebLinkAbout12319 MACLURE DReAK ENCROACHMENT PERMIT CITY OF BAKERSFIELD d PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE +Mry BAKERSFIELD CA 93301 O LIFO (661) 326-3724 TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachment on public property or right of way as therein defined. Application Nuober . . . . . 12-30000039 Date 10/12/12 Property Address 12319 MACLURE DR Application type description PW - ENCROACENR NT PERMIT Owner Contractor HASKINS MATTHEW T 6 RACHELLE B OWNER 12319 MACLURE DR BAKERSFIELD CA 93311 ---------------------------- ___________________________________ Perri[ . . . ENCROACHMENT PERMIT Additional deep . . Phone Access Cade . 1253996 Perrit Fee . . . . 208.00 Issue Date . . . . 10/12/12 Valuation Qty Unit Charge Per Extension BASE F&E 209.00 Special Notes and Comments Place fence behind sidewalk on the aide of house. Fence to be 6- from highest point. Contact: Matthew Hoskins 661-205-8758 ____________________________________________________________________________ Fee summary Charged Paid Credited Due Permit Fee Total 200.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the crit at any time. J 5 Sign ure of Applicant Owner/Agent) Print Name I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL (NOT) SUBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2) WILL (NO UTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE (GRANT DENIED) Said permit shall expire on date stated above. Signature of City Engin e Additional Terms on the Back ENCROACHMENT PERMIT 37 APPLICATION FORM v co CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT .;e A 1501 TRUXTUN AVE gLjFO \ BAKERSFIELD CA 93304 (661)326-3724 Fax: (661) 852-2012 LOCATION OFENCROACHMENT(Address required where available): 1--;l3/G W7,,a,- Dr em 1?331 If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT I/P,,Tfltt. I -//AS K:y5 COMPLETE ADDRESS: PHONE: Cr6/ %�5'/% LNlaa(✓: t /�� FAX: ;balms/s-frG (o'( lm %.311 CELE: PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised PERIOD OF TIME FOR ENCROACHMENT: EFINATE r OTHEk: CONTACTPERSON Mo.7'{"litew PHOI:— Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City,ita officers agents and employees againstany and all liability, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi-judicial, orjudicial tribunals of any kind whatsoever, arising out of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is. revoked. Applicant further agrees that uponthe expiration of the permit for which this application is made, if granted or revocation thereof by the City Engineer, applicant will at his own cot and expense remove the same from the property or right of wax where the same is located, and restore said publicproperty or right of way to the cond. nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment. Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for however long the encroachment remains.. Applicant shall furnish the City Risk Manager with a Certificate. of Insurance evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidencing the insurance required.. The type(s) and amount(s) of insurance coverage required are: Residences: Homeowners General Liability coverage in an amount of at least $300.000.00 Commercial: Commercial Liability coverage in an amount of at least $1,000,000.00 Encroachment Permit Fee: $208.00 SAPERMITSTNCROACIEEncroachment Permit Req Form.DOC January, 2009 Public Works Department 1501 Truxtun Avenue Bakersfield, California. 93301 (661) 326-3724 APPLICATION FOR ENCROACHMENT PERMIT Permit Fee $208.00 To the City Engineer of the City of Bakersfield, California: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachmentonpublic property or right-of-way astherein defines. 1. Full nameof applicant and complete address including phone number: N\ .AA W r��r t�liS ll ict, -D' i X33 t t 2. Nature or description of the. encroachment for which this application is mat, (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc...) T Weld lrk-c. ,�^u�2 m� w00G t-e.nct f('m 1a ,re 't 5 'Ft) 'rirt �`Ctxa ally 3. Location of proposed encroachment: (Example: Side yard at back ofsldewalk or front yard at back of sidewalk) 6-e..x% -6 '6ce2.wa1v— - -_ 4. Period of time for which the encroachment is to be maintainedrIndefmlte or Other. 5. Is property part of a Homeowner's Association -YesNp Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi-judicial, orjudidial tribunals of any kind whatsoever, arising out of, connected with, or caused by applicants placement, erection, use (by applicant or any other person or entity) or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is revoked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon revocation thereof by the City engineer, applicant will at his own cost and expense remove the same from the cubiti property or right of way where the same is located, and restored said public property or right of way to the condition as nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment. Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc- ing the insurance required. The type(s) and amounts) of insurance coverage is: Applicant acknowledges theright of the City Engineer, pursuant to. Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any tmc. 696ncroaUmentPeimitsApplicationforencroachment B .A K E R S E I E L C, Public Works Departmeni 1501 Trurtun Avenue Bakersfield, California 93391 (651) 326-3724 TO WHOM IT MAY CONCERN: We the undersigned, have no objection to the construction of a fencebeside the sidewalk within me Public right-of-way. �2jMU'F L.n By: /✓Iu-likzw �.`"'�6u/e �StG1nS iSvicet for praposetl enerecchr:entj S�'ners Nam_1 of /�3 YV acL Ac �r 2kit� ci-') 9?Yl Phanr Cool -G(a 3-1/1/3 Z (Address of praposed mcroach=n[) SIGNED: 1.) Name: *11PKV/\JY.1jAJ Aaaress: 2.) Name Ad—esi J ! 3Name: .) '�` nfvk CC3CL Address: 17UhlF MMV(f._ 11 Y (��FJlill� /��yyL131 4.) Name: Address. 5.) Name: AOare55: /'�q /a-2 Date: /0-'r -tZ. Dale: -11- Date: (V' I),IZ Date: 5.) Name: Date: Aacress !NS,U.RE 01 ND.~;G NT IS' FC)RN1 A'i!Ord (Named Insured) Name. and Mailing Address MATTHEW HASKINS 12319 MACLURE DR BAKERSFIELD CA 93311 The Residence premises is located at 12319 MACLURE DR BAKERSFIELD CA 93311 homeowners Policv No. 983257612 633 1 Your Insurer Travelers Commercial Insurance Company One of The Travelers Property Casualty Companies One Tower Square, Hartford, CT 06183 TOTAL POLICY PREMIUM This is not a bili; you will be invoiced separately. TRAVELERSJ QAi'� (ni.l.ii, I{7111 7':it: t..:it?.-1 T lfi�a Agent Information CENTEX INSURANCE AGENCY 8407 FALLBROOK AVE STE 200 WEST.HILL, CA 91304 Mortgagee Name and Address. 1. BANK OF AMERICA, NA ISAOA ATIMA. PO BOX 961206 FORT WORTH TX 76161 LOAN NUMBER 209039973 Policy. Period 06/26/12- 06/26/13 12:01 A.M. Standard Time at the residence premises For Claim Service Call For Policy Service Call 1-800-CLAIM33 1-800-842-5075 $., 948;00 Continued on next page 670lOM2244 PL -12830 &06 Insuretl Copy Page t of 4 OCE91410093S F3115CK 7615 05/07/12 r ,. _u _ , Ai.- LIMIT Section I - Property. Coverages A- DWELLING ............................................. _ .................. $. 268.000 B - OTHER STRUCTURES........................................................ $ 26.800 C - PERSONAL PROPERTY........................................................ $ 187,600 D - LOSS OF USE.............................................................. $ 134.000 LIMITED FUNGI, OTHER MICROBES OR ROT REMEDIATION Section I - Property Coverage .......................................... _ ..... $ 5,000 Section II - Liability Coverages E - Personal Liability (Bodily Injury and Property Damage) Each Occurrence.. 8 300.000 F -Medical Payments. to Others Each Person.. .... .................. ........ $ 5,000 Your Savings The following credits or discounts reduced your premium: Loss Free Discount, Protective Devices Discount Deductibles DEDUCTIBLE Section I Property Coverages Deductible (All Other Perils) ................. $ 1,000 Section I .Limited Earthquake Deductible Percentage 15% In case of loss under section I, only that part of the loss over the stated deductible is covered. 'kPTIUN>AL &iii DORSMERA EtNTS ANO C01VIr^RSiGES LIMIT PREMIUM Optional Endorsements HO -55 CA (05-07) Limited Earthquake Coverage ............................ $ 268.00 Masonry Veneer Excluded HO -85 CA (06-09) Enhanced Home Package .................................. Included" Water Back Up And Sump Discharge Or...... $5,000 Overflow Additional Replacement Cost Protection... 50% 438BFU NS (05-42) Lender's Loss Payable Endorsement ....................... Included" h',,AN,u'::i;-0F-( F:r IlISAi`arwl HO -3 (10-06) Homeowners 3. Special Form Continued on next page 67010=44 PL -12630 6.06 Insured Copy Page 2 of(l F d i 2 a. u H r. x 1 3 r - 3 _ c" M 1 � 5 • B A h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager 40 FROM: Bob Wilson, Supervisor II, Subdivisions DATE: October 12, 2012 SUBJECT: Encroachment Permit Application for: 12319 Maclure Dr Name of Applicant: Matthew T Haskins Description of Encroachment Place fence behind sidewalk on the side of house not to exceed 6' from the highest point. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. Madure Dr. doe B A k E R S F S E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor II, Subdivisions DATE: October 12, 2012 SUBJECT: Encroachment Permit Application for: 12319 Maclure Dr Name of Applicant: Matthew T Haskins Description of Encroachment: Place fence behind sidewalk on the side of house not to exceed 6' from the highest point. Please review the attached encroachment permit and return to me at your earliest convenience. 10/22/20/2 WF 5:\PERMITSIENCROACH\TRAFFIC\12319 Madure Dr.Goc